Digital Commons Network^™

An Adaptive Infrastructure Framework For Health Equity Integration Into Clinical Research, Keith Henri Salvado, Elidia V. Tafoya, Latanya Dean, Grissel Hernandez, Neera Ahuja

International Nursing Research Congress (INRC)

PURPOSE: The research team transformed a struggling health equity study by redesigning the clinical research infrastructure using population health management concepts and the A3 improvement methodology. The framework embeds the full cycle of clinical research in high acuity settings. This adaptive, nursing-led transformation aimed to optimize feasibility, to drive equitable access to research, and to bridge gaps in the literature.

METHODS: The research team overhauled the study using A3 improvement methodology within the framework of Lean and Plan-Do-Study-Act cycles. To optimize recruitment, our team developed workflows around sales funnel principles. Culturally competent and linguistically appropriate interactions fostered research access. Strategic …

Addressing Obesity In Rural Health Clinics, Morgan P. Trusley

Student Scholarly Projects

Practice Problem: According to the Centers for Disease Control and Prevention (CDC), more than 2 in 5 adults in the United States are obese (CDC, 2024a). In a rural primary care clinic in South Carolina, approximately 70% of patients are obese and there is no current intervention in place to help educate and guide these patients in weight loss strategies.

PICOT: In obese adults over the age of 18 at a rural health clinic with a Body Mass Index (BMI) greater than or equal to 30, does implementing weekly virtual and in person multicomponent behavioral intervention educational sessions compared to …

Conceptual Framework And Key Considerations For Field-Based Infrastructure In Food Is Medicine Research, Shreela V Sharma, Colleen Tewksbury, Christopher R Long, Colleen Spees, Ronit A Ridberg, Reshma Gupta, Erin P Ferranti, Naomi Tice, Eric Peterson, Brian Levine

Faculty, Staff and Student Publications

In 2023, the American Heart Association launched the Healthcare by Food (HCXF) initiative to establish a rigorous evidence base for Food Is Medicine (FIM) programs, so that patients with acute or chronic disease could access FIM programs as a covered benefit under their health insurance. The HCXF initiative is engaging in research, advocacy, and education to support the development and testing of interventions that improve health outcomes. The HCXF initiative launched 9 task forces aligned with research progress, including the Field-Based Infrastructure task force designed to examine broader questions to help support either earlier or later stages of the HCXF …

The Prophylactic Landscape: Sand And Typhoid On The Merrimack River, Laila Seewang

School of Architecture Faculty Publication and Presentations

“The first municipal water filter of the rapid sand type was built at Somerville, NJ, and thus began its wonderful history.”  By 1917 the rapid sand filter was the standard defense against typhoid epidemics in the United States.

Acceptability And Impact Of Weight Management Interventions For Adults With Intellectual Disability: Protocol For A Systematic Review And Meta-Analysis, Rohit Shankar, Ananya Ananthakrishnan, Edward Meinert, Rosiered Brownson-Smith

Peninsula Medical School

Introduction Obesity disproportionately impacts people with intellectual disabilities (PwID). Given the challenges that PwID face, such as cognitive deficits, differences in motivation and communication difficulties, the need for tailored interventions for weight management in PwID is recognised. Yet, this population is underserved, with limited weight management interventions for them compared with the general population. Existing reviews suggest that ‘multi-component’ interventions (including physical activity and dietary advice) are impactful at reducing weight in PwID; however, less is known about how these interventions are tailored for PwID, particularly in addressing their cognitive and communication difficulties which may influence how they understand and …

Hematological, Inflammatory, And Oxidative Stress Biomarker Profiles In Substance Abuse Combinations: A Comprehensive Evidence-Based Review, Teif Naif Freeh Alenezi, Samia Soliman Barghash

Saudi Toxicology Journal

A potential risk of polysubstance use in relation to substance abuse can involve the development of intricate pharmacological interactions affecting the immune system and oxidative stress responses of the body. The current review aims to present a synthesis of the existing literature about hematologic, inflammatory, and oxidative stress markers associated with three patterns of polysubstance use: (1) stimulants and cannabis, (2) stimulants/depressants and CNS depressants, and (3) multi-drug complex usage. This review explores markers such as a neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), eosinophil-to-lymphocyte ratio (ELR), total oxidant …

Examining Six Domains Of Resilience With Latinx College Students From Migrant Farmworker Backgrounds: A Quasi-Experimental Single Case Design Study, Rebecca Dickinson, Raissa Miller, Cian L. Brown, G Michael Russo, Emma Knowles

Trauma Counseling and Resilience

Resilience-building interventions show promise in higher education, yet few studies focus on Latinx college students from migrant farmworker backgrounds (LMFWs), a group facing significant challenges such as acculturative stress, mixed familial immigration status, and educational discontinuity. This quasi-experimental single-case design study examined resilience domains among LMFW students participating in a group-based intervention informed by the predictive 6-factor resilience model. Resilience was measured across six domains: collaboration, vision, tenacity, reasoning, health, and composure, using standardized assessments adapted from Rossouw and Rossouw (2018). Pre- and post-intervention scores were visually analyzed to assess change at the individual level. Results indicated a evidence of …

Drawn For A Brighter Tomorrow: A Functional Art Workshop As A Path To Livelihood And Skills Development Under The Pasay Social Welfare And Development Department (Pswdd), Liane Oxana V. Estuesta, Giana Margaux D. Bustos, Anne Kirsten Cerish S. Gamayo, Julia Patrish P. Go

DLSU Arts Congress Conference Proceedings

This study examines how functional art workshops, where creativity results in usable, real-world objects, can be a tool for livelihood and skills development among children in need of special protection aged 7-17 under the Pasay Social Welfare and Development Department (PSWDD). Specifically, grounded in arts-based and qualitative research, the study seeks to understand how exposure to functional art-making can support participants’ confidence, agency, and practical competencies. Data was gathered through primary sources, including a needs assessment survey, semi-structured interviews with youth participants and administrators after the program, and visual documentation of completed artworks. Secondary sources were also used, including published …

Effectiveness Of The Smart Me-De Digital Program On Health Literacy And Glycemic Control In Newly Diagnosed Type 2 Diabetes, Nongnaphat Rungnoei, Siriporn Kruttakart, Natthapan Phianthanyakam, Pakaporn Klinhom, Umaporn Nokpaet, Jintipa Sirikunwiwat, Burong Jaitham

Journal of Health Research

Background: Individuals newly diagnosed with type 2 diabetes often have limited knowledge and self-management skills, leading to poor glycemic control and increased complications. This study evaluated the effectiveness of the Smart ME-DE Digital Program in improving health literacy and glycated hemoglobin levels among newly diagnosed individuals with type 2 diabetes.

Methods: A quasi-experimental study was conducted with seventy participants recruited from diabetes clinics at three hospitals in a central province of Thailand. They were selected using simple random sampling and matched by gender, age, and baseline HbA1c levels, and allocated to an experimental or comparison group. The experimental group received …

Pharmacy Professor Uses Grant To Improve Rural Healthcare Access, James Dowd

University of Mississippi News

OXFORD, Miss. – University of Mississippi pharmacy professor Kylie Futrell is leading a partnership working to improve access to healthcare services in rural Mississippi communities, while helping residents manage their chronic health conditions.

Contributions Of Arginine And Nitrosative Stress To Huntington’S Disease Progression, Ian D. Gaudet

Electronic Theses and Dissertations 2020 - Present

Neuroinflammation is a well-established component of Huntington's disease (HD) pathogenesis, yet the intricate molecular mechanisms that govern this process remain a topic of ongoing research and debate. This dissertation elucidates a novel pathway linking arginine metabolism and nitrosative stress to core HD pathology. We found that the arginine transporter SLC7A2 is selectively upregulated in various HD cellular models and patient samples. Our findings reveal that this upregulation drives an overactive inflammatory response, leading to abnormally high inducible nitric oxide synthase (iNOS) induction and subsequent nitric oxide (NO) production, which causes excessive protein nitrosylation and an increase in mitochondrial fragmentation.

To …

Non-Enzymatic Hepatic Abhd6 Interacts With Akt-Foxo1 Axis To Regulate Metabolic Health, Guannan Li, Laurence T Maeyens, Jiyuan Yin, Jan-Bernd Funcke, Chanmin Joung, Ruizhen Li, Ziying Xu, Ting Wu, Xin Li, Nisi Jiang, Mbolle Ekane, Maria Paula Lopez, Pengju Cao, Sijia He, Adam B Salmon, S R Murthy Madiraju, Marc Prentki, Juli Bai, James F Nelson, Xianlin Han, Yi Zhu, Shangang Zhao

Children’s Nutrition Research Center Staff Publications

The enzymatic role of ABHD6 in insulin secretion and resistance is well documented. However, its non-enzymatic function, especially its effects on metabolic health, including selective hepatic insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), is poorly understood. To define the role of ABHD6 in liver physiology, we generated liver-specific ABHD6 knockout mice, as well as liver-specific native and enzymatically inactive mutant ABHD6 overexpression mouse models. We demonstrate that non-enzymatic ABHD6 contributes to the regulation of selective hepatic insulin resistance and MASLD progression. Mechanistically, we show that ABHD6 localizes to the nucleus and interacts with Akt/FoxO1 axis to regulate insulin …

Coping With Adversity: Exploring The Role Of Protective Factors And Their Impact On School Enrollment And Satisfaction Among Adolescents Living With Hiv In Low-Resource Settings, Jennifer Nattabi

Brown School Graduate Student Theses and Dissertations

Globally, an estimated 2.38 million children and adolescents (0–19 years) are living with HIV, with 80% residing in sub-Saharan Africa. In Uganda, adolescents remain at high risk, with approximately 6,600 new infections among 10–19-year-olds in 2023. Despite expanded access to antiretroviral therapy (ART), adolescents Living with HIV (ALHIV) continue to experience poor outcomes, including low viral suppression and high mortality, largely driven by non-adherence. However, ART adherence represents only one dimension of their lived experience. ALHIV must also navigate intersecting adversities, including poverty, stigma, orphanhood, and exposure to sexual and gender-based violence, while meeting academic expectations, particularly in boarding school …

Reflections On Focus Group Participant Recruitment In An Indian Youth Mental Health Study, Debanjali Saha, Ketoki Mazumdar

The Qualitative Report

In this article, I (DS) critically reflected on my journey as an Indian graduate student while navigating dissonant expectations versus reality from the planning to data collection phase of my doctoral research, especially the challenges involved in the participant recruitment process for focus group discussions. The goal of my study was to understand the narratives of various stakeholders of the Indian higher education community on students’ mental health on Indian college campuses using Participatory Action Research strategy with the help of focus group discussions. Recruiting participants was a crucial first step in this endeavor. Six FGDs were conducted with a …

Using Creativity Tools To Improve Perception Of Mental Health Resource Access On A College Campus, Laura Reindl

Creativity and Change Leadership Graduate Student Master's Projects

This paper outlines the planning and implementation processes for executing a Creative Problem Solving (CPS) session at Binghamton University, with the goal of developing new ways to communicate accurate information about mental health resources available to students on campus and refuting common misconceptions. Led by communications and marketing staff in the Division of Student Affairs, the process included staff from Health and Counseling Services, staff involved in delivering health promotion and prevention services, and students with an interest in health and wellness. The project focused on the ideation and development stages of CPS and offered ideas for future implementation.

Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training (Dsmt) To The Fee-For-Service Medicare Population, 2017–2024, Wanying Zhu, Aleksandr Taraskin, Jeffrerey Talbert

Rural & Underserved Health Research Center Publications

Key Report Highlights

• A significant rural DSMT access gap exists. Rural beneficiaries accounted for 20.1% of Medicare beneficiaries with diabetes but only 7.8% of DSMT participants.

• Geographic availability remains limited. Only 16.8% of counties with DSMT utilization were rural.

• Access, not demand, appears to be the primary challenge. Rural counties offering DSMT achieved utilization rates more than twice those observed in urban counties (6.0% vs. 2.5%).

• Expanding rural DSMT capacity may represent a high-impact opportunity to improve diabetes self-management support among underserved Medicare beneficiaries.

Climate Change And Adolescent Girls In West And Central Africa: Building A Girl-Intentional Response, Mame Soukeye Mbaye, Sarah Engebretsen, Maty Dia, Karen Austrian

Adolescents and Young People

The Girls’ Futures in Focus: Evidence from West and Central Africa series examines the challenges facing adolescent girls in the region and highlights evidence-informed approaches to improving their lives. This brief summarizes the evidence on how climate shocks reshape the lives of adolescent girls in West and Central Africa, drawing in particular on evidence from the GIRL Center’s priority countries. It examines gendered climate vulnerabilities, gaps in climate policies that overlook girls, and emerging adaptation strategies that hold promise for girls in the region. The brief points to what a girl-intentional climate response could look like across the priority countries.

Changement Climatique Et Adolescentes En Afrique De L’Ouest Et Du Centre : Vers Une Réponse Centrée Sur Les Filles, Mame Soukeye Mbaye, Sarah Engebretsen, Maty Dia, Karen Austrian

Adolescents and Young People

La série « L’avenir des filles en point de mire : données probantes d’Afrique de l’Ouest et du Centre » examine les défis auxquels font face les adolescentes de la région et met en lumière des approches éclairées par les données probantes pour améliorer leurs conditions de vie. Cette note de recherche synthétise les données probantes sur la manière dont les chocs climatiques bouleversent la vie des adolescentes en Afrique de l’Ouest et du Centre (AOC), en s’appuyant notamment sur les données issues des pays prioritaires du GIRL Center. Elle examine les vulnérabilités climatiques liées au genre, les lacunes des …

Online Group Neurobehavioral Therapy (Nbt) For Veterans With Epilepsy And Major Depressive Disorder (Mdd), Melissa F. Fadipe

Dissertations and Theses (Open Access)

Background: Veterans with epilepsy experience high rates of psychiatric comorbidity, most commonly major depressive disorder (MDD). Barriers to accessing mental health care—including geographic distance, transportation limitations related to seizure-related driving restrictions, and fragmented care between neurology and psychiatry, contribute to the underdiagnosis and undertreatment of MDD in this population. Neurobehavioral Therapy (NBT), a Cognitive Behavioral Therapy (CBT)-informed psychotherapy developed for individuals with seizures, has demonstrated benefits for psychological distress and quality of life. Internet-based interventions and short message service (SMS) text messaging offer promising strategies to address access barriers; however, limited research has examined the feasibility and acceptability of delivering …

Baseline Nutrition Knowledge And Feasibility Of A Whatsapp-Delivered Nutrition Education Intervention Among California Wildland-Urban Interface Firefighters, Lauren E. Anderson

Master's Theses

Wildland firefighters perform physically demanding work under challenging environmental conditions that place substantial demands on nutritional health and occupational performance. Despite the importance of nutrition in supporting physical performance, recovery, and long-term health, limited research has examined nutrition knowledge and dietary behaviors among California wildland firefighters or evaluated the feasibility of remotely delivered nutrition education interventions within this occupational population. Therefore, the purpose of this pilot study was to assess baseline nutrition knowledge, nutrition self-efficacy, and dietary behaviors while evaluating the feasibility of a 12-week WhatsApp-delivered nutrition education intervention among California wildland firefighters.

Twenty-four firefighters completed the baseline assessment and …

Cellular Senescence Links Muscle Atrophy And Posttraumatic Osteoarthritis After Acl Injury, Alexander R. Keeble, Allison Owen, Sara Gonzalez-Velez, Nicholas T. Thomas, Camille R. Brightwell, Peyton J. Balawender, Madeline G. O'Daniel, Helena C. Weiss, Haley Noehren, Heather Thompson, Karen Sofia Zuluaga-Osorio, Zane T. Bates, Lauren Gottlieb, Douglas E. Long, Douglas Harrison, Philip Kern, Caitlin E. Conley, Michael A. Samaan, Stephen Duncan, Austin Stone, Darren Johnson, Yuan Wen, Brian Noehren, Cory Dungan, Christopher Fry

Biology Faculty Publications

Traumatic knee injury leads to posttraumatic osteoarthritis (PTOA) and significant skeletal muscle weakness, resulting in chronic disability. The current standard of care frequently fails to prevent musculoskeletal dysfunction, underscoring the need to identify therapeutic mechanisms of PTOA. Using an established preclinical anterior cruciate ligament (ACL) transection model of PTOA and leveraging an innovative SPiDER-senescence-associated β-galactosidase stain to discern senescent cells, we investigated cellular senescence at single-cell resolution and identified anti-inflammatory macrophages as a predominant contributor to the senescent cell burden in both muscle and knee joint after injury. Clearance of senescent cells using the senolytic dasatinib and quercetin (D + …

Teen Suicide And The Outcomes Of Surviving Peers, Emily Cuddy, Janet Currie, Elisa Jácome, Lucy Manly

Cowles Foundation Discussion Papers

By age 17, a quarter of U.S. students have experienced a peer suicide. Using linked administrative data from South Carolina and a matched difference-in-differences design, we find that exposure to a peer’s self-harm death increases the probability of a self-harm diagnosis by nearly 50% and both the incidence and frequency of mental health visits. Effects on care use and criminal behavior are concentrated among white boys, and responses diverge by prior mental health history: students without a prior diagnosis increase felony offending rather than care-seeking. Deaths from assault and transportation accidents produce no comparable rise in self-harm, consistent with contagion.

Know Your Birth, Jasmine Mckelvey, Reagan L. Hunt, Michaela M. David

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Maternal mortality remains a significant public health concern in rural Kenya because of limited healthcare resources, inadequate emergency obstetric training, and barriers to accessing timely, high-quality maternal care. This quality improvement project evaluated the implementation of the Know Your Birth educational intervention, a culturally responsive, simulation-based training program designed to improve healthcare providers' knowledge, confidence, and competency in evidence-based maternal and newborn care. The project was conducted at Sega Dispensary in Sega, Siaya County, Kenya, and included 26 healthcare staff members. Guided by the Plan-Do-Study-Act framework, participants completed a brief educational presentation followed by three interactive skills stations focused on …

The True Scope Of Trusting Your Gut: A Study Into The Enteric Nervous System And The Relationship Between The Gut-Brain Axis And The Mind, Bryan Pham

Theses & ETDs

Since the early days of medicine, the “gut” had been associated as a seat of emotions and intuition, but as modern science marched forward, the brain itself was given complete dominion over mental health. But thanks to research into the enteric nervous system (ENS), which innervates the digestive tract and bilaterally communicates with the brain as a secondary function, we now know that, in a sense, the gut does indeed have a substantial impact on mental health outside of its primary functions. This profound discovery could potentially cause a massive rewrite for decades of modern neuroscience-based medicine. Overall, the study …

Thermal Conversion Of Cotton Gin Byproducts Into Liquid Fuels And High-Value Chemicals, Emmanuel Asare

Mechanical Engineering Theses

In this study, we performed fast pyrolysis, catalytic fast pyrolysis (CFP), and catalytic hydropyrolysis (CHP) of cotton gin byproducts (CGB) to investigate their conversion into hydrocarbon-rich liquid fuels and high-value aromatic chemicals. Five CGB fractions (CC1, CC2, SM, TM, and FCGB) were collected from different stages of cotton ginning operation and characterized by proximate, ultimate, and higher heating value (HHV) analysis. The feedstocks contained 41.5 44.8 wt.% carbon, 54.2–58.5 wt.% volatile matter, 6.0–15 wt.% ash, and higher heating values of 15.2–16.8 MJ kg⁻¹. All pyrolysis experiments were performed using a Pyroprobe 5200 coupled with GC-MS/FID, while catalyst loading, hydrogen pressure, …

Harnessing Kenyan Aquaculture Through Social Media: Impacts, Challenges And Strategic Directions, Domitila Kyule, Jonathan Munguti, Mavindu Muthoka, Esther Magondu, Menaga Meenakshisundaram, Chrysantus M. Tanga, Kevin Obiero, Cecilia Githukia

All Peer-Reviewed Publications

Aquaculture is increasingly important for food, nutrition and livelihoods in Kenya, but the sector still faces persistent constraints in extension delivery, farmer learning, input access, market coordination and information reliability. This review examines how social media and related digital communication tools are shaping aquaculture development in Kenya, with attention to impacts, challenges, governance needs and strategic directions. A systematic literature review of studies and institutional sources published between 2015 and 2025 was conducted. The search identified 388 records, of which 45 sources were included in the final synthesis after screening, eligibility assessment and quality appraisal. Because the evidence was heterogeneous, …

Analyses Of Atheroprotective Effects From Mir-33a Deletion In Primary Vascular Smooth Muscle Cells, Achala Pokhrel

All Theses

Atherosclerosis is one of the major causes of cardiovascular disease, characterized by the accumulation of cholesterol and foam cells within the arterial walls. Foam cells were traditionally believed to originate from macrophages; however, recent studies have shown vascular smooth muscle cells are also capable of accumulating cholesterol and developing foam-cell-like characteristics. ATP-binding cassette transporter A1 (ABCA1) plays an important role in removing excess cholesterol from cells by transporting intracellular cholesterol to circulatory apolipoprotein A-I (apoAI). MicroRNA-33a (miR-33a) is known to suppress ABCA1 expression and limit cholesterol efflux. However, its role in primary aortic smooth muscle cells is unknown and not …

Addressing Food Pantry Capacity To Offer Medically Tailored Groceries For Food Insecure Individuals With Chronic Disease In Rural South Carolina, Anna G. Taylor

All Theses

This study examines the feasibility of implementing medically tailored grocery (MTG) programs within rural food pantries in South Carolina to better serve food-insecure individuals living with chronic diseases. Using a mixed-methods design, the study aimed to assess current pantry capacity, identify barriers and facilitators to MTG implementation, and evaluate strategies to strengthen MTG delivery.

The intervention was guided by three implementation science frameworks: the Six-Step Knowledge Sharing Model, the Consolidated Framework for Implementation Research (CFIR), and the RE-AIM evaluation framework. Data collection occurred in two phases. In Phase 1, statewide focus groups, capacity surveys, and inventory assessments were conducted to …

Effects Of Beverage Color During Mouth Rinsing On Measures Of Muscular Endurance, Muscular Strength, And Exercise Perceptions During Isometric Handgrip Testing, Sydney Andrews

Exercise Science Theses & Dissertations

Previous research has shown that color can influence psychological responses, physiological responses, and exercise performance. These effects have been previously attributed to learned associations or expectations which may influence exercise-related outcomes. This study aimed to investigate whether beverage color influences muscular performance during intermittent isometric handgrip exercise. This randomized, single-blind, deceptive crossover study consisted of 34 physically active adults (21.9±3.1 years) who completed a handgrip endurance test under three conditions: red beverage rinse, clear beverage rinse, and no-rinse. Participants were informed that the study would examine the effects of mouth rinsing two commercially available carbohydrate containing sport drinks on muscular …

Evaluating The Discus Throw As An Ancient Greek Combat Training Tool Through Modern Performance Metrics, Daniel R. Porter

All Graduate Reports and Creative Projects, Fall 2023 to Present

This study’s purpose was to explore the correlations between peak velocity in a rotational throw with a medicine ball, peak force (PF) and rate of force development (RFD) in an isometric mid-thigh pull, time to failure in a plank test, and peak velocity in a sword thrust task, which was also tested for reliability. Twenty-seven recreationally trained male participants between the ages of 18-35 completed the study. The sword thrust task was significantly correlated with the medicine ball throw (p = 0.012, r = 0.475, r² = 0.226, 95% CI [0.724, 0.116]) and PF (p = 0.045, r …